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September 16, 2025Journal of Bone and Joint Surgery2 citations

Injection-Based Therapies for the Management of Hip and Knee Osteoarthritis

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MSMatthew SeahMNMichael E. NeufeldLHLisa C. Howard

Key Points

  • Corticosteroid injections are mostly safe, but patients should consider risks of side effects and limited efficacy.
  • Routine use of hyaluronic acid injections is not advised, yet some patients may find them beneficial after failed therapies.
  • Local anesthetics may enhance pain control with corticosteroids, but concerns exist regarding potential chondrotoxicity.
  • Evidence remains insufficient for prolotherapy and mesenchymal stromal cell injections, though intra-articular saline may improve function.

Abstract

➢ Corticosteroid injections are largely safe, but patients and practitioners should be aware of the small risk of adverse side effects, and their limited duration of efficacy. The timing of injection should be coordinated with potential surgical dates.➢ The routine use of hyaluronic acid injections for osteoarthritis is not recommended, but there are certain subsets of patients, such as those who have undergone other therapies that failed, who may benefit from it.➢ Local anesthetics are frequently used in conjunction with corticosteroids for enhanced pain control; however, caution is needed because of concerns regarding chondrotoxicity. Proper patient selection is crucial, and their overuse for diagnostic purposes is not recommended.➢ There is currently insufficient evidence to support the routine use of prolotherapy, bone marrow aspirate concentrate, stromal vascular fraction, and mesenchymal stromal cell injections.➢ Intra-articular saline solution has been associated with improvements in both patient-reported pain and function scores, and this should be considered in future study designs.

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Cite This Study

Seah et al. (2025) studied this question.

synapsesocial.com/papers/68d4539c31b076d99fa59614https://doi.org/10.2106/jbjs.25.00239
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